This application requests renewal of funding for five years to support our postdoctoral training program in critical care health policy research (CCHPR). The overall goal of this program is to develop skilled investigators trained to conduct health services research and capable of academic careers as independent researchers improving the quality and safety of critical care medicine. All trainees enroll in the Masters of Science in Health Policy Research (MSHP) degree program-offered by Penn's School of Medicine and its Wharton School. The program has been highly successful attracting, training, and graduating trainees in its first few cohorts. Trainees receive an intensive, structured program of mentoring, didactic research training, and experiential research over two years. The program includes core courses in health economics, health policy, qualitative/quantitative measurement, and statistics; elective courses in advanced epidemiology or biostatistics, advanced health care economics, health care policy, statistics, survey design and measurement, and social policy and demography; intensive mentoring in critical care health services research by experts in the field; participation in multidisciplinary research and professional development seminars; instruction in the responsible conduct of research and regulatory affairs; and the development and completion of a clinical research project in critical care medicine under close supervision of a multidisciplinary mentoring team. The program is designed for postdoctoral physician fellows with clinical experience in adult and pediatric critica care. The definition of critical care encompasses care for adults and children with severe acute medical problems, trauma and post-surgical care in intensive care units, coronary care units or emergency departments. The program emphasizes research on policy- relevant issues in critical care outcomes, financing, delivery, and management, often in contexts that are collaborative and interdisciplinary. Program participants will gain the skills necessary to combine their clinica expertise with their research training in order to ask and answer important questions about how critical care is and ought to be organized, financed, managed, and delivered.